(county where Complaint filed) _______________________________, Case No. CI _____________ (name of plaintiff on original action) (case number assigned by clerk of court) Plaintiff, vs. _______________________________, (name of defendant on original action) Defendant. CERTIFICATE OF COMPLETION OF PARENTING EDUCATION COURSE 1. I am the _________________ in this action. (plaintiff or defendant) 2. On _________________, I completed a parenting education course (date) given by one of the organizations approved by the State Court Administrator’s Office. 3. I have attached to this Certificate of Completion of Parenting Education Course the paper I received from the Parenting Education Course provider that proves I completed the course. Nebraska State Court Form CERTIFICATE OF COMPLETION OF PARENTING EDUCATION COURSE Page 1 of 1 Certificate of Completion of Parenting Education Course DC 6:5.5 Rev. 01/2020 DC 6:5.5 Rev. 01/2020 Neb. Rev. Stat. § 43-2928 Date Signature Name Street Address/P.O. Box City/State/ZIP Code Phone E-mail Address